Psychological Disorders and Treatment 2009 Online

Psychological Disorders and Treatment : 

Psychological Disorders and Treatment

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Psychological Disorders and Treatment Demographics Disorder? Symptoms? What caused the disorder? What will happen in treatment?

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The “Medical Model” abnormal behavior = disease Diagnosis Etiology Treatment/ Prognosis

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BioPsychoSocial model - Abnormal behaviors = multiple causes.

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“Diathesis – Stress Model” Diatheses (Risk factors) x Stress (Exceeds Coping Resources) = Increased Vulnerability to Disorder

What is abnormal behavior? : 

What is abnormal behavior? A continuum of normal/abnormal

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Personal Suffering/ Other Distress - involves physiological, emotional, and cognitive symptoms.

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Some Criteria for Abnormality

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Some Criteria for Abnormality

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- A personal inability to pursue and achieve goals vital to functioning as a person. Disability/Dysfunction

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Disability/Dysfunction

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Some Criteria for Abnormality

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Danger

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Some Criteria for Abnormality

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Strange and Rareness This criteria is part statistical, it is infrequent behavior. Schizophrenia (1%)

Psychodiagnosis: Classification of Disorders : 

Psychodiagnosis: Classification of Disorders Diagnostic and Statistical Manual of Mental Disorders – 4th ed. DSM - IV is a Multiaxial system for diagnosis Axis I: Clinical Disorders

Psychodiagnosis: Classification of Disorders : 

Psychodiagnosis: Classification of Disorders Diagnostic and Statistical Manual of Mental Disorders – 4th ed. DSM - IV is a Multiaxial system for diagnosis Axis I: Clinical Disorders Axis II: Personality Disorders and Mental Retardation.

Psychodiagnosis: Classification of Disorders : 

Psychodiagnosis: Classification of Disorders Diagnostic and Statistical Manual of Mental Disorders – 4th ed. DSM - IV is a Multiaxial system for diagnosis Axis I: Clinical Disorders Axis II: Personality Disorders and Mental Retardation. Axis III: Disorders due to a General Medical Condition. Axis IV: Psychosocial and Environmental Problems Axis V: Global Functioning

Selected Clinical Syndromes : 

Selected Clinical Syndromes Anxiety Disorders Mood Disorders Schizophrenic Disorders

Anxiety Disorders : 

Anxiety Disorders

Anxiety Disorders (27-28% prevalence) : 

Anxiety Disorders (27-28% prevalence) Panic disorder and agoraphobia Physical symptoms of anxiety/leading to agoraphobia

Anxiety Disorders (27-28% prevalence) : 

“free-floating anxiety” Generalized Anxiety Disorder Anxiety Disorders (27-28% prevalence)

Do you worry excessively about minor things?” : 

Do you worry excessively about minor things?”

Anxiety Disorders (27-28% prevalence) : 

Post Traumatic Stress Disorder (PTSD) Anxiety Disorders (27-28% prevalence)

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Phobic disorder Specific maladaptive focus of fear

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Virtual Exposure Treatment for Phobias

Anxiety Disorders (27-28% prevalence) : 

Anxiety Disorders (27-28% prevalence) Obsessive Compulsive Disorder (OCD) Obsessions/ Compulsions

Anxiety Disorders (27-28% prevalence) : 

Anxiety Disorders (27-28% prevalence) Social Anxiety Disorder social situations/evaluations

Etiology - Anxiety Disorders : 

Etiology - Anxiety Disorders Biological factors Conditioning and learning Genetic predisposition GABA Acquired - classical conditioning or observational learning Maintained - operant conditioning

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Cognitive factors Personality Stress Judgments of perceived threat; excessive worry; rumination High Neuroticism Etiology - Anxiety Disorders

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Treatment

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Treatment for Psychological Disorders Therapist Orientations (APA Data, 1989)

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Treatment for Psychological Disorders

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Psychodynamic (Freud): goal -process unresolved unconscious conflicts

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Techniques – dream analysis, free association, analysis of transference

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Client Centered (Rogers) – goal is to restructure self-concept to better correspondence with reality

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Techniques – accurate and genuine empathy, unconditional positive regard

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Cognitive Therapy (Beck) – goal is to recognize and changing negative thoughts and maladaptive beliefs.

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Techniques – cognitive restructuring – ABC, journaling, thought records Cognitive Therapy

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Behavior therapies - Changing overt behavior Systematic desensitization

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Behavior therapies Systematic desensitization Exposure Therapy Aversion therapy Social Skills Training

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Aversion Therapy Nauseating Substance (UCS) Aversion (UCR) Nauseating Substance paired with Bad Habit (CS) Aversion (UCR)

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Biomedical therapies Biological functioning interventions

Mood Disorders (20-25% prevalence) : 

Mood Disorders (20-25% prevalence) Major depressive disorder Dysthymia depressed nearly everyday for at least 2-weeks long-term mild depression, typically less severe than Maj. Dep.

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Seasonal Affective Disorder (SAD) seasonal depression

Mood Disorders (20-25% prevalence) : 

Mood Disorders (20-25% prevalence) Post Partum Depression depressed state following childbirth

Mood Disorders (20-25% prevalence) : 

Mood Disorders (20-25% prevalence) Bipolar disorder Manic (Bipolar I) or Hypomanic (Bipolar II) and normal mood/ depressive states.

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Episodic patterns in mood disorders

Etiology of Mood Disorders : 

Etiology of Mood Disorders Genetic vulnerability Genetic predisposition, mood disorder sensitivity

Etiology of Mood Disorders : 

Etiology of Mood Disorders

Etiology of Mood Disorders : 

Etiology of Mood Disorders Neurochemical factors low levels of norepinephrine and/or serotonin

Etiology of Mood Disorders : 

Etiology of Mood Disorders Cognitive factors negative thinking, pessimistic explanatory style, excessive ruminating

Example of Pessimistic Explanatory Style : 

Example of Pessimistic Explanatory Style

Aaron Beck’s Cog Model of Depression : 

Aaron Beck’s Cog Model of Depression

Etiology of Mood Disorders : 

Etiology of Mood Disorders Genetic vulnerability Neurochemical factors Cognitive factors Interpersonal roots Precipitating stress social support; skills difficulties

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Interpersonal factors in depression.

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Effectiveness of Various Therapies and Meds for Major Depression

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Effectiveness of Various Meds for Major Depression

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Schizophrenia (1% prevalence) Thought disorders marked by delusions, hallucinations, disorganized speech, and deterioration of adaptive functioning.

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Deterioration of adaptive behavior Schizophrenia (1% prevalence) Positive Symptoms Delusions Hallucinations Negative Symptoms Blunted and constricted emotions

Subtypes of Schizophrenia : 

Subtypes of Schizophrenia Paranoid type Catatonic type Disorganized type Undifferentiated type Persecution or Grandeur Delusions striking motor disturbance incoherence, disorganization. not fitting into other categories.

Etiology of Schizophrenia : 

Etiology of Schizophrenia Genetic vulnerability

Etiology of Schizophrenia : 

Etiology of Schizophrenia Neurochemical factors high dopamine (pos symptoms), low serotonine (neg symptoms), interactions with other neurotransmitters

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Structural differences in the brain Etiology of Schizophrenia correlation between enlarged ventricles in the brain and the occurrence of schizophrenic behavior.

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Neurodevelopmental hypothesis – early brain insults increase vulnerability for schizophrenia

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Expressed emotion and Stress Etiology of Schizophrenia